Ibs

[Billie]

Thought I would bring this topic forward, one I am trying to deal with personally.

All my life I have had bouts of diarreha, constipation was never an issues unless traveling. I have been reading lots and have been to the doctor and that is his suspect, IBS.

I have had a colonoscopy and it was all clear and he did a battery of blood work apparently you have to disregard other illness to make a diagnosis towards IBS. The blood work came back fine. He did an inventory with about 25 minutes of questions, how about when and where. I truly have had it since I was a small child. Emotions can trigger an episode but apparently there is something that circuits your intestines from your brain...heck I dunno.

Just wondering if anyone else here suffers from the maladity, what your particular symptoms are and how you cope.

[Mitra]

Billie, you have my sympathy, I have a friend with IBS, and it's caused her a lot of distress over the years. I don't suffer from IBS personally, but I thought I'd add in what it says in PPLP. (I'm sure you know it already, but others reading the thread may not.)

It's in the chapter on the Leaky Gut. It's suggested that those with "severely disordered intestinal tracts" such as sufferers from Crohn's disease, ulcerative colitis, severe IBS (with cramping and chronic diarrhea) or who have suffered trauma to their bowels start out on PP with a "gut rehab" programme for a few days (usually less than a week). The details of the programme are in the book, but it uses whey powder, L-glutamine, Magnesium, Potassium & cod liver oil - yum :( - but it's only for a few days). Then they suggest following the purist version of PP, at least initially. Legumes and grains seem particularly troublesome.

[Gaelen]

Billie, you may also want to investigate "Breaking the Vicious Cycle: Intestinal Health through Diet" by Elaine Gottschall. You can find the book on Amazon.

Gottschall in conjunction with Dr. Sidney Valentine Haas quantified the Specific Carbohydrate Diet, which is compatible with Protein Power Phase II, but a bit different from PP Purist (and the differences make it much easier to maintain, although the beginning diet is no picnic to comply with, and following SCD 100% forever is, IMO, as difficult for anyone who ever eats in a public place or food they don't prepare at home as following PP Purist is.)

SCD has a documented history of improving IBS, IBD, ulcerative colitis, celiac disease and other GI disease symptoms, and "Breaking the Vicious Cycle" is provides extensive references both in the book and at online sites that discuss it. When my gynecologist and internist initially thought that what I had might be IBS/IBD (which can only really be diagnosed by biopsy), they recommended that I try one of the diets recommended for IBS, and I chose SCD specifically because it's PP-compatible. To the extent that it could work, it did...but stress definitely plays a role in IBS/IBD flare ups and in times of physical or mental stress, I would have a flare-up no matter how well I was eating. And of course, what I had wasn't IBS, either. :eek:

SCD eliminates grains, nearly all processed foods, all artificial sweeteners. It doesn't eliminate legumes and beans, but only allows them to be added in after all symptoms are under control. The only allowed sweeteners are honey, and some limited use of natural stevia, although some web references not yet updated still include saccharine. FOS or inulin (the fiber added to SteviaPlus, and to many low carb things) is not permitted. Allowed proteins include any variety of fresh or frozen meat or fish, canned fish in oil or water without added soy protein, eggs, cheese, homemade yogurt, dry curd cottage cheese, kefir, nuts and seeds, and beans and legumes prepared from fresh or dried beans/legumes. In the beginning, nuts and seeds are only allowed as flours until diarrhea stops. Yogurt must be homemade, and no canned fruits or vegetables are allowed at any time. Processed meats and deli meats are not allowed. Thickeners such as agar agar, not-starch, thicknthin, carrageenan are not permitted. Mozzarella and ricotta cheese are not permitted, because of their high lactose content.

The first phase of the diet is very restrictive--homemade everything, and only including boiled, poached or scrambled eggs, chicken soup, yogurt, gelatin made from organic unsweetened fruit juice and unflavored gelatin, broiled ground meat or broiled fish, cheesecake from dry curd cottage cheese, diluted unsweetened apple cider or unsweetened 100% grape juice. No raw fruits or vegetables, no cooked vegetables except the ones cooked in the soup. When intestinal problems stop, additional permitted foods may be added in, one at a time, to isolate foods that may still cause problems.

Here are some internet references:
Elaine Gottshcall's official website (http://www.breakingtheviciouscycle.info/) which includes scientific references, the intro diet for people waiting for book delivery, recipes and other online links--start here!

http://www.breakingtheviciouscycle.org/

The Introductory SCD Diet (from EG's official site) (http://www.breakingtheviciouscycle.info/beginners_guide/the_intro_diet2.htm)

"Leaky Gut Syndromes: Breaking the Vicious Cycle" by Leo Galland, MD (http://trainland.tripod.com/leaky.pdf#search='breaking%20the%20vicious%20cycle ')

http://www.scdiet.com/ -- a commercial site where you can also order Gottschall's book (if Amazon is backordered) as well as complementary cookbooks, etc. Also outlies the book and has Chapt. 1 online to read.

The SCD Web Library (http://www.scdiet.org/) -- more information than anyone can possibly digest in one visit... ;)

SCD information at The Healing Crow website (http://www.healingcrow.com/dietsmain/scd/scd.html) -- remember Seth from the old PP board? He is The Healing Crow. ;)

BTW, my nut muffins recipe was based on a cross between the muffins/biscuits recipes that were on the old boards with the standard muffin recipes on the SCD recipe sites. I still follow some of the dietary recommendations, because diet post-colostomy included establishing what foods I could/couldn't tolerate. I decided to start with the basic SCD, and expand outward from there.

Hope this helps. I know that SCD does.

[Missy]

Hi Billie....I can relate! I was going to recommend the section of Leaky Gut that the Eades's wrote about as a place to start...but Mitra BEAT ME...again.....sheesh....you gotta be QUICK around here!!! :rolleyes: lol :D

I too had this happen to me often in my life...especially when I was unhealthy and eating whatever, which was ALOT of fast food meals...and under a great deal of emotional stress...that was my "chronic stress" part of my life. Anyways, it would effect me by just after eating a meal..sometimes, I'd have to RUSH to go to the bathroom within minutes after eating...and it would cramp me till I went and got rid of it. Sorry about the details...but, that's what it was like for me.

I had explained this all to my new doctor and that's what he explained to me that I was experiencing...Leaky Gut. I don't find I have that problem these days, but I cook at home a great deal of the time now.

My mother has a great deal of intestinal problems now...and is a diabetic that IGNORES having it...:rolleyes: and eats a bunch of stuff she souldn't...and well, I just take it as a further "sign" of things to come for me if I don't turn it around NOW.

Part of what I feel I DID to help me improve...amoung doing everything medically (hormones, thyroid, now diet, exercise) is to also seek therapy for the emotional prison I felt trapped in. My "former" doctor's advise was to put me ON an antidepressent...or in her words "or you don't want to have to see a therapist, do you?" :rolleyes: ~ no...no...DRUGS are best and should always be the first choice! :rolleyes: NOT!!!!....see why she is now my FORMER Dr!!!!!!! ~ anyways, after switching to my new Dr, that's what his suggestion was for me (therapy), and I took it. My point is, that by doing so, it helped ME resolve my emotional agony...and helped me establish boundries...therefore, feel like I mentally gained my control back, therefore I didn't allow my emotions to get the best of me. The emotional stressor's where my trigger I believe for that leaky gut problem.

Gosh, I can't believe how MANY subjects are effected and related. Well, actually, after writting that...it's probably due to the fact that it's SO ingrained with us that the things "wrong" with us aren't interrelated because they are "treated" seperately...when actually they are COMPLETELY related and should be seen as a WHOLE.

The leaky gut bone is connected to the brain bone...the brain bone is connected to the menstruation bone....the menstruation bone is connected to the thryoid bone.....come one everyone SING WITH ME!!!!! :D

[Billie]

Ah thanks for the info and the reminders. My symptoms very well could be stress related. And they are not hugely impeding. But as I am a worrier, I worry much more than I should and I do think that exascerbates the condition. I remember as a child being the star in the 4th grade play and I was home ill with stomach and intestional illness--my mom saw me eating a ham sandwich and said, you are scared--which of course only made me realize I was scared and sent me packing to be in the play. Another time in adulthood, we were camping and a snake crawled into the campground (probably 20 years ago, I am really afraid of snakes) and I had instant diarrehea. So these symptoms are not anything new at all.

For example yesterday I found out my friend who is quite ill is now not taking chemo. I don't know if it is to have some life to live, or if they want to let her regain some of her strength. She has been quite ill and in the hospital this last week. As well my youngest son got engaged and I found that out on Friday morning, certainly not a sad day but nonetheless exciting. I don't really have pain at all, just the diarrehea and very occasional cramping.

So worry and stress are really big players for me and I know have some effect. I don't think it is diet related somehow, or at least minimally so.

[Missy]

Billie, I'd like for you to turn this into a "June Challange" and see what you can dig up...Gaelen has given a great start....but this is something I'm more curious about too.

"Worry" and "Stress" did it for me too. I rarely have it now....but I don't know exactly why?

[Missy]

I also have VERY DRY flaky patches on my face..on my cheek near my nose, and in my eyebrow...after reading up on one of Gaelen's sites above..I see it can be related?? Under Diseases Associated with increased Intestinal Permeability...oh, dang, I can't remember which link it was now...but, I was curious if anyone else can relate to this symptom? And, if so, any suggestions?

[Gaelen]

Stress IS a big factor in IBS...and this article, which came over the Medwire-News Gastroenterology alerts today examines a study where they attempted to quantify the differences in reactions to stressful situations between subjects with IBS and control who didn't have the syndrome. I've included the whole article here because reading the article requires a registration/login to the site. Medwire-News registration is free; newsletters provide daily updates of recent medical journal articles in subject areas you choose, and delivers a synopsis of the day's pertinent articles to your inbox. If you'd like to check out the site, it's http://www.medwire-news.md/default.aspx

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IBS patients have nonspecific stress response
14 June 2006
Eur J Gastroenterol Hepatol 2006; 18: 629-636

German study findings indicate that individuals with irritable bowel syndrome (IBS) have an altered and generalized response to emotional stress, but not an overall exaggerated stress response.

Hubert Mönnikes, from Universitätsmedizin Berlin, and co-workers explain: "The evidence for stress reactivity in IBS has yielded ambiguous results, regarding responses to physical and mental stress."

The team therefore investigated the effect of an emotional stressor - a public speaking anticipation task - in 12 patients with IBS and 12 healthy individuals without the disorder.

In order to elicit an emotional stress response, participants were notified - without warning - that after approximately 20 minutes they would have to make a speech that would be transmitted via a video link to a group of psychologists who would evaluate the contents of their talk.

All participants were instructed to make a speech on the same subject, and stress responses were recorded at baseline and during the 20-minute anticipation phase.

Individuals with IBS had a significantly higher heart rate than healthy controls at baseline, at 74.5 versus 65.2 beats per minute, respectively. The former individuals also reported significantly elevated values in stress parameters compared with controls at baseline, including higher levels of anxiety, excitement, and palpitation.

Notably, IBS patients elicited a significant change in heart rate in anticipation of the speech delivery, with values during this phase increasing to 84.1 beats per minute, compared with a decrease to 63.4 beats per minute in controls.

However, the overall pattern of stress response during the entire duration of the task was similar between the IBS and control groups, and in contrast to what was expected from previous studies, the blood pressure of the individuals in each group did not differ significantly.

Rectal sensitivity to stress did not differ between the two groups, although IBS patients had lower discomfort thresholds than healthy controls during all phases of the task.

Reflecting on the fact that there is a clearly more pronounced elevation in heart rate during an emotional stressor in individuals with IBS, Mönnikes et al propose that IBS patients may exhibit a "more generalized and unspecific stress response than healthy subjects."

They continue in the European Journal of Gastroenterology & Hepatology that this finding "allows the conclusion that stressful events might be perceived as more dramatic and disturbing by IBS patients than by normal controls."

free abstract (http://www.eurojgh.com/pt/re/ejgh/abstract.00042737-200606000-00009.htm;jsessionid=GPtQNWvQygmLjyKGjkwM0yWvjn1nL zvD0pWRG1Q9wm9h3D0zn2lG!-1110070904!-949856144!8091!-1)
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[Billie]

That's interesting and I do think that stress causes my problems. However I think I can identify what stressors set me off and try to deal with them that way. For example, giving a speech like this would not rise my BP or heart rate one bit, now let me worry about my kids and I am there in a flash!

I appreciate the study and I want to personally learn as much as I can about it all so if you come by one I would love the link or the posting for sure.

This human body of ours is so wonderfully complex isn't it!

[Gaelen]

Billie, I think that even when the docs thought my cancer was IBS, I knew in my heart and gut that it wasn't. IBS was then and still is the current 'hot' diagnosis when nothing else seems to fit--just as mono was a popular diagnosis when I was in college whether it was correct or not, and for awhile many diagnoses (Epstein-Barr or chronic fatigue syndrome, ADHD, bi-polar disorder) seem to get over-applied while spotlit with 15-minutes of fame. That's not to say they aren't all legit diagnoses, but they all can be, have been and are over-used. And when I'd have a stress flare-up (btw, it can be mental, emotional or physical stress) it would always be after spending a couple hours on an ice-cold set of bleachers, watching a close lacrosse game in sleet or pouring rain (ain't CNY weather grand?). I was coming off an 8+ hour workday, focusing every bit of positive energy on my nephew 1) coming off the field at the end of the game unhurt, and 2) him having a good game (playing well). Was I stressed? Not to my mind or the observer's eye...but physically, I was pushing my body to the max and emotionally I was in knots anytiime any player went down and didn't get up--lacrosse is an aggressive, physical game and kids get hurt.

The thing with stress, which always seemed to trigger an attack in me no matter how I was eating, is that it can so often not be truly recognized by the sufferer. I (usually) never consider myself 'stressed' in the dog show ring, for example, unless the situation is extraordinary...Casey being in the winner's class in conformation at a major regional specialty where I was going up against famous and very well-respected breeders and handlers showing a red dog to a judge that didn't like solid colored english cockers; Reuben showing for the first time with his new owner in a new sport (and her in a wheelchair on a tight course!). And watching my culinary entries judged...oh man, those times are stressors. But a standard dog show class or cooking for a culinary entry I usually classify as 'no worries,' although I can tell by the dog's reactions and my friends' reactions and my sleep patterns during show weekends that I'm not truly stress-free.

You know what's wrapped me around the axle for the last few days, although I was not recognizing it? The family across the grass with whom I've become very good neighbors started their move today...they're going half-way across the country to KC.

I've known it was coming for a couple months, discussed strategies for transporting two cats, a two-month-old infant and an active four-year-old on a very long caravan car trip with both parents, even had all the talks you have with four-year-olds about how they will meet NEW friends (and new puppies to play with) in their new homes. We've exchanged pictures and little gifts and kidded around about the things they WON'T miss about our homeowners' association but which I'll still face. We have all tried to always be upbeat and positive, especially to reinforce good feelings about the move for Madeleine.

But Monday when I saw my longtime counselor, he pushed me to talk about how I'm feeling about their move, about realizing that I will never see Madeleine grow up or hear her squealing "Pat and Casey are out" or put Casey through his paces while she 'trains' him in our shared back yard. On the up side, none of the grownups that are part of her life will have to confront the issue of me dying when she's so young...we all dodged that bullet! Her mom's a surgeon, so we've all been very honest about me being sick, and she will explain to any listener why some days I wear a fanny pack or can't walk Casey, when and why another neighbor's old dog died, and why the local zoo's elephant lost her calf. But we haven't talked about ME dying, and it's a bit of a relief that now none of the adults will have to have that talk with her. Not sure that's worth trading off not continuing to be a part of her life as she grows up. :(

Last night when Maddie brought out a gift for Casey (a new frisbee) and handed me a Lowe's gift card to 'grow more garden!' I worked very hard to be happy and positive, although I really wanted to cry. Saved tears for today, when I got home from treatment and unfolded a note from her parents with new address/phone. It's a bittersweet time...exciting for all of them, but sad, too...and stressful for all of us. Sometimes being the 'strong adult' in that situation is harder on everyone than it needs to be, and we could all take a cue from the four-year-old, who is both excited by the 'adventure' of traveling and all the new zoos they plan to visit on the trip--but also wants to be back in time to walk Casey, Dudley and Annie this weekend, and can't quite connect the dots that make that impossible. ;)

It's been six years I've been seeing this counselor, and I'm still not always good at recognizing or admitting to my 'silent' stressors...although he's excellent at it. :p

Anyway, long story short, the article talked about the effectiveness of cognitive therapy for stress control, and in my experience that has been invaluable--whether the final diagnosis is IBS, stress, or none of those things, or some combination of each.

[blueriversam]

I have been suffering for a really long time with some sort of weird bowel issues. I started to see another gastroenterologist. Once again, they did not find *anything* wrong with my gall bladder, which was the initial diagnosis. The doctor wanted to do an endoscopy. I went in, they put the IV in for a light sedative, and I passed out and proceded to convulse [I was not aware of this] from the vaso-vagal reaction. They through me into the ER for hours, until I was seen by a neurologist, who told me I just passed out and I was fine. Needless to say, I am so terrified of doctors and hospitals now that I nearly passed out in the dentist's office and I ran out of there and have not scheduled an appointment to see my GI dr or my dentist since. My GI dr wants to put me under general anesthesia next time, but that requires actually walking into the hospital and getting yet another IV, passing out, and being sent to the ER for another happy visit. The thought makes me queasy. Anyways, I just deal with my stomach and intestinal problems and it hasn't been *too* bad in a while.

Thanks for the references, I have been meaning to ask about it because I have no clue what to eat except my doctor told me not to eat anything except well-cooked vegetables. I was like, uhm, what about for ENERGY?

[laughingW]

That's interesting and I do think that stress causes my problems. ...
This human body of ours is so wonderfully complex isn't it!
Well you have already been given so much info my head would be swimming with what to work on next... but this all reminded me of the movement side of things to handle stress.

The father of stress said later that if English had been his native language, he would have said "strain" instead of stress. You know, where strain is the result when stress goes so far as to hurt or deform what is being stressed.

What is not much talked about is that exercise can not only relieve stress, but allow you to be more resilient - to take more stress without strain.

I learned this from an exercise program that's specifically designed to help train to handle stress without strain. I use it and it's really quite amazing.

Just another interesting take on the body-mind connection with stress and strain.